George V: Mercy or Convenience?

George V grandfather of the current British monarch, Elizabeth II was born in 1865 and died on the 20th January 1936.  He reigned from the 6th May 1910 until his death.  He is notable for being the reigning monarch during the first world war. 

(George V)

Like many men of his generation, including the son who would take his name when he followed him onto the throne, George V was a heavy smoker.  This took a toll as he aged, resulting in chronic obstructive pulmonary disease (emphysema) and recurrent lung infections. 

On the 23rd of September 1928 George V became seriously ill.  He was found to be suffering from an empyema (an abscess in his lung) which in turn spread to his bloodstream.  His doctor, an highly respected physician named Lord Dawson of Penn, operated to drain the fluid.  The King's life hung in the balance for several weeks, but he eventually made a slow recovery.  Already a Baron, an honour granted for previous service to the royal family, Lord Dawson found himself on appointed to the Privy Council in 1929 and became a minor celebrity. 

 (Lord Dawson of Penn)

Seven years later, however, the King's health had continued to decline.  In his final year his breathing was so poor that oxygen was occasionally required.  On the 15th of January 1936 he complained of a cold and took to his bed.  It became clear that he would not leave the room again and his family were summoned. 

Over the next five days George V slipped in and out of conciousness.  However according to most reports, notably from the Archbishop of Canterbury, he remained comfortable during this time and did not seem to be in any pain.  On the 20th of January at 925 pm his end seemed near and Lord Dawson released a statement to the media.  "The King's life is moving peacefully towards its close." 

At five minutes before midnight on the 20th January 1936 George V was pronounced dead, the cause being bronchitis.  He was interred at Windsor Castle eight days later. 

George V was succeeded by his son Edward, a reign that lasted only 11 months prior to his abdication, then his son Albert, who reigned as George VI. 

Thanks to his work caring for the King in the final stages of his life, Lord Dawson was elevated to the rank of Viscount.  He continued to have an illustrious medical care, remaining in the medical household of the Royal Family as well as treating foreign monarchs.  He died in 1945, aged 80, and was lauded in the media. 

The above, for example is an obituary that appeared in Melbourne's the Argus on the 8th August 1945.  It's final paragraph:  "Possibly Lord Dawson will be best remembered as one  of the three physicians - the others were Sir Frederick Williams and Sir Stanley Hewitt - who fought desperately to save the life of King George V in January, 1936.  To him is attributed the beautiful wording of the bulletin released a few hours before the death of King George on January 20, 1936.  This, it will be recalled, read: "The King's life is moving peacefully towards its close"."

However, this is where things get murky.  

In 1986, fifty years after the events discussed here, Lord Dawson of Penn's private diaries were found and made public.  The following entry was noted concerning King George V's death.  

“At about 11 o'clock it was evident that the last stage might endure for many hours, unknown to the patient but little comporting with the dignity and serenity which he so richly merited and which demanded a brief final scene. Hours of waiting just for the mechanical end when all that is really life has departed only exhausts the onlookers and keeps them so strained that they cannot avail themselves of the solace of thought, communion or prayer. I therefore decided to determine the end and injected (myself) morphia gr.3/4 and shortly afterwards cocaine gr. 1 into the distended jugular vein.”

Lord Dawson acted without the knowledge of the other two doctors caring for the King.  The nurse involved in the case, Catherine Black who had cared for George V since 1928, was aware of what was occurring but refused to give the injection herself.  Whatever her thoughts on the matter, she remained silent for the rest of her life, making no mention of the incident even in her autobiography published in 1939.

As to whether the royal family were aware, reports are conflicting.  When these reports first came to light, Buckingham palace refused to make extensive comment, prefering, as is there want, to keep the controversy buried.  However while Queen Mary and her sons are on record in Lord Dawson's diary as saying they wanted no measures to prolong George V's life, nothing was said about hastening his death.  It seems unlikely that the deeply religious Queen Mary would have approved.  

The motivation of Lord Dawson appeared to be threefold.  Firstly, he frankly admitted that he wanted to ensure that the death would occur prior to midnight.  Thus it would ensure that the King's death would be published in the Times, not one of the lesser evening tabloids.  To ensure this occurred, Lord Dawson's telephoned his wife and asked her to let the Times know when the death announcement was about to occur. Secondly Dawson had a lucrative private Harley Street practice that he needed to return to.  

Finally, given he had already issued a bulletin stating that death was close, Lord Dawson had an interest in proving his prediction correct.  

Lord Dawson is notable for speaking, and voting against a euthanasia bill in the houses of parliament a little under twelve months later.  However interestingly his public stance against it was more that he felt the decision belonged to the doctor. Euthanasia "belongs to the wisdom and conscience of the medical profession and not to the realm of law".  Effectively he espoused the concept of 'mercy killing'. 

Some seventy years later, his actions still do not sit well.  It is a stretch, even for ardent advocates, to call Lord Dawson's action in the case of George V euthanasia, given that the patient was comfortable, unconcious and unable to give consent.  The only person who benefited in this event was Lord Dawson himself.  To quote JHR Ramsay, this was much more of a 'convenience killing'.

Interestingly some years later, Queen Maud of Norway, George V's sister, travelled to England for a visit in October 1938.  She was completely well when she left.  However a month after her arrival she became suddenly unwell, requiring abdominal surgery on the 16th November 1938.  She survived the surgery but died of heart failure four days later.  

None of this would seem particularly unusual in a time period where surgery was a much more dangerous undertaking.  However a letter to Maud's Norwegian physicians takes on sinister overtones in light of the preceding.  

Lord Dawson, who cared for Maud, wrote: “When reading this account, you will agree that the Queen’s sudden death was a relief and which saved her from these last painful stages of the disease both you and I know only too well.”

The letter suggests that the cause of Maud's death may have been cancer not heart failure.  And although circumstantial, one wonders if her death was also hastened in a similar way to her brother's. 

It seems highly unlikely that Dawson would have used this technique only the once.  

As the world's most prolific serial killer shows, sometimes this method of murder can be very easy to hide.  

Sources:

http://www.bioedge.org/index.php/bioethics/bioethics_article/9821/

Ramsay, JHR (1994)'A King, a doctor, and a convenient death' British Medical Journal, 308:1445.1

http://en.wikipedia.org/wiki/Bertrand_Dawson,_1st_Viscount_Dawson_of_Penn
http://en.wikipedia.org/wiki/George_V